Lockdown blues as ARVs run out

Lockdown blues as ARVs run out

Over 800 Basotho stranded due to lockdown

MASERU-ABOUT 800 Basotho who are on antiretroviral treatment are stranded in South Africa as they cannot come back to Lesotho to refill their supply of pills because of the lockdown in both countries.
These are official statistics based on Basotho whose presence in South Africa is well documented.

The number could be higher as many Basotho stay and work in South Africa illegally.
According to a study on the “Exploration of Constraints for Free Movement of People in Africa – A Case of Lesotho and South Africa” by Sipho Mokoena and others, Lesotho contributes over 40 percent of the people who pass through South African borders from all neighbouring countries.

Many end up settling in Maseru, only returning home periodically to collect medication such as ARVs.
According to a government minister, many of those who rely on local facilities for ARVs are stuck in South Africa with no idea on how to return home and collect their monthly and quarterly supply of their medication.
Deputy Minister of Health ’Manthabiseng Phohleli, this week told thepost that the affected Basotho do not know how they are going to get their monthly and quarterly supply of their medication.

They cannot travel within South Africa to reach to the border to the equally locked down Lesotho border, she said on Tuesday.
Many Basotho could not make it back home before the lockdowns took effect due to reasons that include lack of money to pay for transport and the fear of being stuck back home with no means of returning to work.

A Mosotho medical doctor working in the Department of Health in South Africa and prefers anonymity shared a conversation between him and a devastated Mosotho patient who lives in Harrismith.
The patient’s three month’s supply of ARV’s had run out and was worried that the lockdown extension which was announced by South African President Cyril Ramaphosa last week would “kill her”.

Luckily, according to the conversation, the patient was later able to get a week’s supply of ARVs from a local public health facility in Harrismith after sharing her story with a nurse there.

“I don’t know the name of the pills because I was just given enough for a week in my bottle,” she writes to the doctor.
She is scared that she might default on her medication and requested the doctor to help her secure enough to last the lockdown.

Her sibling could collect her supplies from a local hospital but is likely to find it difficult to get them to South Africa due to the strictly enforced lockdown.

The doctor asked her to return to the South African clinic and ask for more medication to keep her going at least until the lockdown is over.
The doctor says in 2016 Lesotho and South Africa agreed to ensure that people who are on a cross-border ARV distribution programme be given at least six months’ supply of drugs.

However, Lesotho, which operates cross border clinics in Maseru and Maputsoe, can only afford to hand out three months’ supply of drugs to beneficiaries.
This adds to the existing problem of health systems in both Lesotho and South Africa which are struggling to provide proper care and treatment for HIV infected migrants.

According to a study by Iyiola Faturiyele and eight other co-authors, service providers indicated a lack of transfer letters as the major drawback in facilitating care and treatment for migrants.
This is followed by discrimination based on nationality or language.
Service providers indicated also that most patients preferred all treatment services to be rendered in Lesotho as they perceived the treatment provided in South Africa to be different and “less strong” or has more serious side effects.

Even before the outbreak of coronavirus and the lockdowns, hundreds of migrants from Lesotho were already defaulting on their medication, according to studies.
According to a story published in thepost newspaper earlier this year by health care practitioners titled “The pill or the job” most of the defaulters are from Mohale’s Hoek, which is in the southern part of the country bordering South Africa’s Eastern Cape Province.

Almost all health centres and hospitals in Mohale’s Hoek are experiencing challenges with the migration of HIV/AIDS patients to South Africa who then default on their medication, according to the publication.
During the financial mitigation national address by the Prime Minister Thomas Thabane last week, Minister Tlohelang Aumane said that the ministry of health was organising to have ARV medication sent to the Lesotho embassy in South Africa.

The doctor who spoke to thepost described the plan as “interesting but not practical”.
The doctor said some of the migrants work in the most remote areas that getting to the embassy is impossible during the lockdown.
He said others work in farms, factories and homes that are located far from the embassy.

He put forward three options:
First, that the ministry stock-up supply by cross-border clinics and allow patients to collect them from these two points.

Second, patients be given transfer letters to get their medication from their nearest health centres as long as they have a password, ID or residential address to be given medication and third, that Basotho on medication be repatriated, quarantined in Lesotho after screening and testing.
“However, there is a risk of job losses. Undocumented immigrants may be scared,” he said.

Deputy Minister of Health, ’Manthabiseng Phohleli told thepost that the issue was on the agenda of a meeting held on Monday.
She said the Monday ministerial meeting discussed two options.
The first option was to request the South African government to supply Basotho ARV patients with medication with the promise that the Lesotho government would later pay for the medication.

“We believe that this is the best option for us because we cannot locate every Mosotho on ARVs within South Africa and we cannot have the medication in central places because some may not be able to access them,” Phohleli told thepost.

She said the plan is to have patients go to the nearest health facility with their documentation to be given the type of ARV they are on.
The second option is to request the United States funded PEPFAR programme to accommodate and supply Basotho in South Africa with medication within their hotspot regions.

“We think this is the second best option but we are concerned about people’s proximity to the hotspot regions and ability to get there. Some might make it while some might not,” Phohleli said.
Phohleli said it is imperative for Lesotho and South Africa to work out modalities for migrants to access ART treatment in the host country.

“We hope to see this happen not only in South Africa but in the region and at some point in the continent. We need our people to access health services without hiccups in Africa,” said the minister.
“Health does not know boundaries, rivers or country names. Health is non-discriminatory and we need to accommodate it as such,” Phohleli said.

Rose Moremoholo

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